At Kern Health Systems (KHS), known as Kern Family Health Care (KFHC), compliance and ethical conduct mean doing the right thing while serving the community. The KHS Compliance Program, including our Code of Conduct, is designed to demonstrate our commitment to establishing an environment that promotes the highest level of legal and ethical behavior. Our Compliance Program further supports KHS’ overall commitment to ensure we have the organizational capacity, leadership, financial well-being, commitment to invest in our communities, and demonstrated ability to ensure program integrity and compliance with all applicable federal and state requirements and the standards under our contract with the Department of Health Care Services (DHCS).
- Outlines the key elements of the Compliance Program
- Provides the structure through which Kern Health Systems ensures compliance
- Incorporates our Code of Conduct and the organizations expectation that all involved act ethically and are responsible for ensuring compliance with the DHCS contract and all regulatory requirements
- Acts independently of operational and program areas without fear of repercussions for uncovering deficiencies or noncompliance
- Strives to reduce or eliminate Fraud, Waste and Abuse (FWA)
- Prevents, detects, and corrects any areas of non-compliance
- Provides a delegation reporting and compliance plan
As one of the fundamental building blocks of any Compliance Program, the KHS Code of Conduct articulates our commitment to complying with all contractual and regulatory requirements, and reinforces our core values of trust, respect, and integrity.
This commitment extends to all Kern Health Systems employees, officers, and our board of directors, as well as our network providers and subcontractors. The code of conduct reinforces our organizational expectation for all involved to act ethically and ensure compliance.
KHS remains fully responsible for all duties and obligations of our contract with the DHCS and all regulatory requirements. However, KHS may enter into agreements with others to assist with our obligations. KHS does not fully delegate, but we do have subcontractors with expertise in certain areas to support KHS in providing high-quality health care to our members.
Kern Family Health Care (KFHC) is responsible for adhering to the roles and responsibilities for coordinating care, exchanging information, and conducting administrative actives related to Members accessing and receiving care per the Memorandum Of Understandings (MOUs) written by DHCS to managed care plans (MCPs). KFHC and KFHC’s Network Providers and other providers of carveout programs, services, and benefits as well as authorizing Medically Necessary Covered Services must comply with all requirements set forth in APL 23-029 or any subsequent version of the APL.
KFHC is committed to working collaboratively and jointly with regional partners to hold quarterly meetings to discuss and address care coordination and MOU-related issues. In good faith efforts, we are publicly sharing the date and time of quarterly meetings.
Kern Behavioral Health and Recovery Services (KBHRS) MOU.
Non-Specialty Mental Health Services | Member and Provider Outreach and Education Plan
Utilization Assessment of Non-Specialty Mental Health Services for Medi-Cal Members
Emergency Preparedness and Response Plan
MCP-MHP Clinical Meeting Information:
QI Meeting
Wednesday, March 20, 2024
12:00pm - 1:00pm
Q2 Meeting
Wednesday, June 19, 2024
10:30am - 11:30am
Q3 Meeting
Wednesday, September 18, 2024
10:30am - 11:30am
Q4 Meeting
Wednesday, December 18, 2024
10:30am - 11:30am
As living documents, the KHS Compliance Program; Code of Conduct; Compliance Guide, Delegation Model; and Delegation Reporting and Compliance Plans will be reviewed on an annual basis and updated as necessary to reflect the needs of the organization.